122 Rules by Deek Rhew

Friday, January 4, 2019

Cholesterol Scare - Part 2: Not as Scary as We Thought?

If you haven't read my first blog post, Cholesterol Scare, where I got back my lipid profile back and was startled to find my numbers almost double the legal limit, stop in and give it a read.

Over the last six months, I've lost 32 pounds on the keto diet. During that time my migraines have all but vanished, my energy levels are way up, my body fat % has dropped a ton, and I feel great. So, all good things. Unfortunately, my blood work up wasn't what we'd hoped.

As I mentioned in my last post, I'm not a doctor, just a guy with Google and extra fat packets in his bloodstream. So, in this blog post, I'm going to give you the research I found that says that not only does cholesterol NOT cause heart disease. But having elevated levels may actually make you live longer and fight off cancer, diabetes, and other diseases.

US and UK Translations
If you or someone you love has high cholesterol (and you're in the States), you'll want to convert your mg ratings to mmol/L that they use in the UK. A lot of the data I'm linking to is from there and almost all their reports and articles use mmol/L instead of mg. To do that use the OMNI Calculator.

Alright, you have your report from the doctor, you have it in mg and mmol/L. On with the research!

Are You a Lean Mass Hyper Responder - LMHR?
For years, I've known I'm a bit over the top. What I didn't know was that my body is too!

One of the things that Erin discovered is that there is a segment of the population that reacts differently to keto than all the rest. This subgroup is known as Lean Mass Hyper Responders. Basically, what it means is that when you get your body fat low, and you are on a high-fat diet, your cholesterol levels and LDL go through the roof.

Most people respond by a serious drop in cholesterol, but not us LMHRs! We get excited about it and want more and more! But, it's not necessarily a bad thing. Read on to see why.

Is there an inverse relationship between high cholesterol and heart disease?
Dr. ZoĆ« Harcombe--Ph.D. in Public Health Nutrition--is off the charts brilliant and working dilligently to weed fact from fiction. Check out her write up about the relationship between heart disease and cholesterol. This article explores the fascinating purpose of cholesterol in our bodies. It's in our brains, it's the mechanism that delivers energy and nutrients to every cell, and, oh yea,  we would be DEAD without it.

I honestly had zero idea about its plethora of purposes which range from digestion, to reproduction, to mental functions. She also talks about how LDL and HDL aren't actually, cholesterol at all, but proteins.

Wut? Yep. So anytime you hear or read someone that says LDL is "bad" cholesterol and HDL is "good" cholesterol, they are wrong. They're actually lipoproteins, hence:
LDL - Low Density Lipoprotein
HDL - High Density Lipoprotein
AKA: NOT cholesterol

Dr. Harcombe ran several reports from the World Health Organization database trying to find a correlation between elevated cholesterol and cardiovascular death. She actually found that the higher the level, the lower the death rate from cardiovascular episodes especially in women.

The question she poses is: Do we have cholesterol completely wrong?

Another leading researcher, Dr. Malcolm Kendrick, did a massive amount of studying on the correlation--or, by his research--the lack thereof, between elevated cholesterol levels and cardiovascular death. Below you find his 30 minute presentation and I think you find it incredibly fascinating.

The long and the short of it is that the relationship between elevated levels and death are actually inverse.

Wut the wut?

Yes. According to his report, the lower your cholesterol the HIGHER your chances are of dying from a cardiovascular episode.

Wait! My doctor told me it's in my genes!
Yes. Me too. What our doctors are talking about is Familial Hypercholesterolemia or FH. Unfortunately, FH isn't nearly as common as we are lead to believe. FH is a genetic mutation and is revealed by a simple test. Usually what happens is that your doctor says you have FH because you have high cholesterol.

Maybe, but probably not. Check out Dr. Harcombe's article that reports only 1 in 500 people actually have the gene. Here's another great article by Dr. Axel Sigurdsson on FH mutation carriers.

Cholesterol, Triglycerides, Ketones, and Lipoproteins
Wow. What a mouthful. Just the sheer number of syllables in the title makes my eyes blur and my head swim. Fortunately, this article on CholesterolCode.com makes it easy to understand what each of these components are and why we need them.

Another Lean Mass Hyper Responder
Stephen Richert is a documentary adventure photographer. In 2015 he was diagnosed with very high cholesterol--his numbers are almost exactly the same as mine. But he has the added complication of having diabetes. Here's his first article in 2015 when he talks about being on keto and getting those results back.

As of 2017, he was still doing keto and still has high cholesterol numbers. However, he is no longer trying to "fix" the lipid levels. Here's his reasoning.

How do I know if I'm Healthy?
Okay, so if cholesterol levels are not necessarily the best indicators of your cardiovascular health, then what are? Unfortunately, there's nothing that's 100% guaranteed, but our research has turned up two tests that can give you a really good idea.

CIMT - Carotid Intima-Media Thickness Test

CAC - coronary artery calcium scan

What's Next for Me
Now that we've ruled out thyroid, cortisol, and any other health-related causes, we've decided to switch my statin (I've been on one since I was in my early 20s). I'm changing from Lipitor to Crestor's lowest dose (half of what I was on before). I'm also modifying my keto diet slightly. Instead of staying below 50g (usually well below) of carbs a day, I'm upping it to 100g.

The extra carbs are almost all veggies and a little bit of fruit. I'm good with this since I've reached my weight goal and am switching to maintenance.

We are pretty certain that I'm a LMHR--remember I'm over the top about almost everything!--but we want to be totally sure. I know that changing two things kinda skews the results, but being on such a low dose should cut down on potential side effects if we decide to increase it.

Right now, we are going to see what happens to my levels over the next two months. It's a make a change, then wait kinda game. But I'm in it for the long haul.

Still haven't decided my feelings on the health benefits of high cholesterol. Still need to do more research--which I will share--and weigh that with the risks of more statins.

Until next time, my friends, adventure on!

Ready to see what happens next?
And the Two Month Follow-Up.

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